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Oral Cancer

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What is oral cancer?

Oral cancer is a malignant growth that affects any part of the oral cavity, including the lips, upper or lower jaw, tongue, gums, cheeks, and throat.

What are some signs or symptoms of oral cancer?

Some signs of oral cancer may be:

  • a red or white patch or lump anywhere in mouth for more than a month
  • a sore in the mouth that bleeds easily or does not heal
  • problems chewing, swallowing, or moving the tongue and jaw (these are later symptoms)

What are the effects of oral cancer on speech and swallowing?

The effects of cancer on speech and swallowing depend on the location and size of the growth. For example, a sore or lump on the lips may limit movement. This could result in unclear production of speech sounds made with the lips such as /p/, /b/, and /m/. Limited movement of the lips might also reduce a person's ability to hold food in his or her mouth when eating. Cancer of the tongue can cause problems with some sounds, such as /l/ and /r/. It may also limit the ability to move food around the mouth or push food back toward the throat during swallowing. A growth on the roof of the mouth (soft palate) or in the throat may change the nasal quality of the voice.

The outcomes after surgery depend on the location and size of the cancerous growth. Other important factors include the amount of tissue removed in surgery, the frequency of speech/swallowing treatment, and the motivation of the patient.

In some cases, reconstructive plastic surgery or the use of prosthetic devices can restore oral functioning to near normal levels.

How is oral cancer diagnosed?

Dentists and doctors are often the first to notice signs of oral cancer during regular checkups. Speech-language pathologists (SLPs) also make note of unusual or abnormal growths during oral examinations and provide referrals to appropriate medical professionals.

SLPs are important members of the cancer team. They perform assessments, both before and after surgery, in addition to treatment.

Standard articulation (speech sound) tests are used to evaluate how clearly the person speaks. To assess how much air escapes through the nose, the SLP uses critical listening skills to analyze and describe resonance patterns. Sometimes X-rays and special instrumentation are used to evaluate nasality problems.

If a swallowing problem exists, additional tests may be recommended. These tests may include an X-ray called a "modified barium swallow" or an endoscopic evaluation that involves a small fiberoptic tube being inserted in the nose and passed down to the back of the throat.

What treatments are available for individuals with oral cancer?

Evaluation and treatment by an SLP are important to restore speech intelligibility and swallowing skills.

Treatment often includes helping people get used to the differences in the size, shape, and feel of their mouth. The SLP will also teach the person how to produce speech sounds more clearly. Oral exercises help the client develop better control over weakened muscles in the throat or palate and to correct nasality problems.

Treatment for swallowing problems varies from simple changes in food consistency to exercises for weak oral muscles to learning totally new ways to swallow. In many cases, improvement is evident within several months.

What other organizations have information about oral cancer?

This list is not exhaustive and inclusion does not imply endorsement of the organization or the content of the Web site by ASHA.

What causes oral cancer?

The following may increase your risk of oral cancer:

  • cigarette, cigar, or pipe smoking
  • smokeless tobacco (e.g. plug, leaf, and snuff)
  • excessive use of alcohol
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How common is oral cancer?

Oral cancer is the sixth most common cancer in the world. At least 30,000 new cases of oral and oropharyngeal cancers are diagnosed each year. Incidence rates are greater than 2:1 male-to-female for oral cavity cancers, and the rates are greatest in men over age 40.

Remission of cancers of the lip and oral cavity varies depending on the stage and specific site. Most patients who present with early cancers of the lip are highly curable by surgery or by radiation therapy, with cure rates of 90% to 100%.

Additional information is available from the American Cancer Society.

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